Medicaid Expansions

This bill constitutes the last step in the O’Malley-Brown Administration’s three-year effort to use the tools of the Affordable Care Act to enhance Marylanders’ access to quality and affordable health care. The bill puts in place the remaining policies necessary for the State’s health benefit exchange to begin operations and expands Medicaid eligibility to ensure coverage for the State’s most financially vulnerable. 

The Centers for Medicare and Medicaid Services (CMS) has issued its final rule on the increased Federal Medical Assistance Percentage (FMAP) rates under the ACA. Beginning in January 2014, the federal government will cover 100 percent of the costs of newly eligible Medicaid beneficiaries through 2016, and then it will phase down to a 90 percent match rate by 2020.

This checklist prepared by the National Academy for State Health Policy (NASHP) highlights the ACA Medicaid requirements that will take effect in the next two years, nearly all of which will apply to states regardless of whether the state chooses to expand Medicaid eligibility.  The checklist also highlights a few important optional provisions that states may want to consider as they plan for modernizing their Medicaid programs and complying with federal requirements.

The ACA expands Medicaid to 138% FPL in 2014, which would make millions of adults newly eligible for the program. However, if a state does not expand Medicaid, poor uninsured adults in that state will not gain a new coverage option and will likely remain uninsured. This brief provides an overview of current Medicaid and CHIP eligibility levels for nondisabled children and adults to provide better insight into the impact of the Medicaid expansion.

This brief prepared by Manatt Health Solutions examines some of the legal, policy and operational issues states should contemplate while considering the possibility of using “premium assistance” to purchase coverage for Medicaid-eligible adults in the Exchange. It provides an overview of the benefits of premium assistance along with the logistical challenges of its implementation.